Family-based therapies for adolescent alcohol and drug use: research contributions and future research needs

Authors

  • Howard A. Liddle

    Corresponding author
    1. University of Miami School of Medicine, Miami, FL, USA
      Howard A. Liddle
      Center for Treatment Research on Adolescent Drug Abuse
      Department of Epidemiology and Public Health
      1400 NW 10th Avenue
      Suite 1108
      University of Miami School of Medicine
      Miami
      Florida 33136
      USA
      E-mail: hliddle@med.miami.edu
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Howard A. Liddle
Center for Treatment Research on Adolescent Drug Abuse
Department of Epidemiology and Public Health
1400 NW 10th Avenue
Suite 1108
University of Miami School of Medicine
Miami
Florida 33136
USA
E-mail: hliddle@med.miami.edu

ABSTRACT

Objective  To characterize the developmental status of the family-based adolescent alcohol and drug treatment specialty by identifying and discussing research and clinical advances.

Method  Selective and interpretative literature review and analysis.

Study selection  Controlled trials and mechanisms of change studies of family-based treatments for adolescent alcohol and drug misuse.

Results  Clinical innovations of family-based treatments include development of detailed therapy, training/supervision, and adherence manuals. Different family-based treatments have been tested with success in controlled trials and process studies. Different versions of the same approach might vary on parameters such as treatment dose, setting, and client characteristics. Research advances include findings that engagement and retention rates for family-based treatments are superior to standard treatment engagement/retention methods. Also, in clinical trials in which they are compared with alternative interventions, in the majority of studies, family-based treatments produce superior and stable outcomes with significant decreases on target symptoms of alcohol and drug use, and related problems such as delinquency, school and family problems, and affiliation with substance abusing peers. Mechanisms of change studies support the theory basis of family-based treatments. For instance, improvements in family interaction patterns coincide with decreases in core target alcohol and drug misuse symptoms.

Conclusions  Once in the shadows of the adult substance abuse field, the adolescent substance abuse specialty has become a unique, clinically creative, and empirically-based area. Research and clinical advances of family-based treatments have implications for non-family-based interventions in the adolescent substance misuse treatment specialty.

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